Provider Demographics
NPI:1326833005
Name:BIRATU, FANUEL
Entity type:Individual
Prefix:
First Name:FANUEL
Middle Name:
Last Name:BIRATU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 18TH ST UNIT 200
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-4078
Mailing Address - Country:US
Mailing Address - Phone:347-822-2742
Mailing Address - Fax:
Practice Address - Street 1:10 E 18TH ST UNIT 200
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-4078
Practice Address - Country:US
Practice Address - Phone:347-822-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)